1114014578 NPI number — DAVID W HUNTER MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114014578 NPI number — DAVID W HUNTER MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

HUNTER

Provider First Name:

DAVID

Provider Middle Name:

W

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1114014578

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

06/29/2018

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

420 DELAWARE ST SE

Provider Second Line Business Mailing Address:

MMC 292

Provider Business Mailing Address City Name:

MINNEAPOLIS

Provider Business Mailing Address State Name:

MN

Provider Business Mailing Address Postal Code:

55455

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

612-273-6004

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

7505 METRO BLVD STE 400

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

EDINA

Provider Business Practice Location Address State Name:

MN

Provider Business Practice Location Address Postal Code:

55439-3010

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

612-573-2200

Provider Business Practice Location Address Fax Number:

612-573-2274

Provider Enumeration Date:

10/06/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 2085R0204X , with the licence number:  21762 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 2T406HU . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
• Identifier: 1622536 . This is a "MEDICA-CHOICE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
• Identifier: 16-02032 . This is a "MEDICA-PRIMARY" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
• Identifier: 300072659 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 457373100 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
• Identifier: HP21393 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
• Identifier: 0051340 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
• Identifier: 124377 . This is a "U CARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
• Identifier: 595910 . This is a "ARAZ" identifier . This identifiers is of the category "OTHER".
• Identifier: 080010 . This is a "FAIRVIEW" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
• Identifier: 1010325 . This is a "PREFERRED ONE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
• Identifier: 1998195 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".